Pulmonology #6 (Respiratory Infections) Flashcards
(39 cards)
What happens if you try to treat children under 18 with Aspirin?
Reye Syndrome!! has a 30% fatality rate
Symptoms of influenza
-Abrupt onset of headache, fever, chills, malaise, myalgias (involving legs)
-Dry cough, eye pain, GI symptoms
What diagnostics can be done for influenza?
rapid nasal swab or viral cultures
Treatment for influenza…
Who gets antivirals?
Supportive: Acetominophen
Antivirals: is hospitalized or 65 years or older
–Oseltamivir within 48 hours of symptom onset (not given under 12 years old)
–If in a long-term facility, all residents get it regardless of vaccine history
What are contraindications to BOTH flu vaccines?
Anaphylaxis to vaccine
Guillan-barre Syndrome within 6 weeks after a flu vaccine
High fever
Infants < 6 months of age
Who can get the inactivated flu vaccine?
How about the live attenuated vaccine?
Inactivated: 6 months or older (including pregnancy)
Live: 2-49 years old
What are contraindications to the live attenuated flu vaccine?
Immunocompromised, pregnancy, 50 years or older, or have taken antivirals within the last 48 hours
What are the three phases of Pertussis (Whooping Cough)?
What phase are the children most contagious in?
Who does this normally occur in?
1) Catarrhal Phase: URI symptoms lasting 1-2 weeks
2) Paroxysmal Phase: severe coughing fits with inspiratory whooping after cough. Post-tussive emesis.
3) Convalescent Phase: resolution of cough
Catarrhal most contagious
Children under 2 years old
Treatment for Pertussis
-Supportive: oxygen, nebulizer
-Macrolides if needed
What is the vaccine schedule for pertussis?
DTap in 5 doses: 2, 4, 6, 15-18 months, 4-6 years old.
Booster at 11-18 years old.
What is the MCC of lower respiratory infection in children?
What is the key diagnostic to determine prognosis?
RSV
Pulse oximetry
Acute bronchitis is inflammation of the bronchi. It is MCC by ________.
What are some symptoms of this condition?
Viruses
Cough: present for at least 5 days, 1-3 weeks
-Malaise, dyspnea, hemoptysis
-Follows a URI
-Wheezing, Fever
How do you prevent acute bronchitis?
What’s the treatment?
H. Flu vaccine
Supportive: fluids, rest, humidifier
Acute bronchiolitis is infection of the bronchioles (smaller airways). This is MC in ______ and the MCC is ______
Children under 2 years old
RSV is the MCC
Symptoms of acute bronchiolitis
What is the treatment?
Viral prodrome for 1-2 days followed by respiratory distress
Supportive: IVF, humidified oxygen
-Handwashing is preventative
What can you give to prevent bronchiolitis?
Palivizumab if born < 29 weeks or has congenital heart disease
Acute epiglottitis (Supraglottitis) is MC in _______ and what is the MCC? Remember this cause may have changed due to a vaccine.
What’s another cause in adults?
MC in 3 months - 6 years
H. Influenzae B MCC until vaccines (Hib).
If immunized, suspect Group A Strep
Cocaine is a cause in adults
Symptoms of supraglottitis
Dysphagia, Drooling, Distress
-Odynophagia, fever, inspiratory stridor, tripping, hot potato voice
-Refuses to lie supine
What is the definitive diagnostic for supraglottitis?
What is seen on XR?
What should you NOT do?
Laryngoscopy: cherry red epiglottis with swelling
Soft tissue lateral cervical XR: thumb or thumbprint sign (enlarged epiglottis)
Do not try to visualize with tongue depressor
Treatment for supraglottitis?
Maintain airway first (OR best setting for intubation)
Prevention with Hib vaccine
ABX: Ceftriaxone or Cefotaxime
What can you give to close contacts to prevent acute epiglottitis?
Rifampin
MCC of Laryngotracheitis (Croup)
Parainfluenza Virus Type 1
Symptoms of Croup
-Upper airway involvement (harsh, seal-like barking cough)
-Inspiratory stridor
-Hoarseness
-Low grade fever
-Symptoms worse at night
-Coryza (URI symptoms)
What is seen on front cervical radiographs with Croup?
Steeple sign (subglottic narrowing of airway)
